Community Snapshot: Engaging Black Pastors in the Quick Response Team (QRT)—City of Huntington QRT. The City of Huntington, WV partners with Cabell County Emergency Medical Services (EMS), Marshall University, local law enforcement, treatment and recovery providers, and pastors to form and deploy the QRT to locations with a high number of drug overdoses. The QRT includes a paramedic, treatment provider, law enforcement officer, and unique to Huntington, is the inclusion of a faith leader. Although Cabell County has a low population of Black/African Americans, opioid overdose deaths in Cabell County occur at a disproportionately high rate compared to the national rate. The City of Huntington QRT’s emphasis on involving the faith community, especially for Black/African American communities, has been pivotal in developing trust between people with SUD and who are at risk for opioid overdose. Initially, there was some reluctance among the faith leaders. But with the opportunity to connect one on one with people in their communities living with OUD, many faith leaders in this community have become champions of this cause and are helping engage individuals to seek treatment. Faith leaders, spearheaded by the Huntington Black Pastors Association, are being trained in understanding opioid misuse and treatment and reducing stigma. They are educating faith communities and families to be supports for people with SUDs. As one key informant noted, “With the Black community the stigma is there, even among the Black pastors. They felt individuals were replacing one drug for another (as in MAT programs), but now working on the streets [they] realize this is not the case.” The QRT offers their support in assisting high-risk individuals with OUD to not only seek treatment, but also educating about naloxone. They are linking with community partners to provide naloxone training and distribution to family members, individuals with OUD, and others in their community. 5. Create a culturally relevant and diverse workforce-- "[We] have trained Black peers, but not a Black supervisor." Communities know that when people feel welcomed, understood and comfortable, they are more likely to continue treatment. In many situations, it is
information that is compatible with the target audience’s lifestyle. Talking about stigmatized health issues such as OUD is a first step to dispelling misinformation and reducing stigma. Pastors can use this medium to convey that these are diseases and illnesses, not sins. Pastors without an online presence but who are involved in or educated on health and social issues in their communities are more likely to discuss these issues, like the opioid epidemic, in their Sunday morning sermons from the pulpit. Identify community-embraced first responders. While the Surgeon General’s call to action—for the use of naloxone for people living with OUD—may be embraced by mainstream, medically engaged communities, this is not always the case for communities that have historically been marginalized and underserved by the health care system. In some Black/African American communities, naloxone has had a mixed reception. Some community members express concern that the availability of naloxone could promote substance use among Black/African Americans. They also fear that seeking naloxone from traditional first responders, such as law enforcement and emergency medical technicians (EMTs), may result in punitive consequences. Despite the mixed reaction to naloxone from some Black/African Americans, some communities are identifying their own first responders. These include community-based organizations, community health workers, family members, and faith-based leaders, and training them to administer naloxone. More education and awareness tailored to Black/African American communities and conveyed by “trusted messengers” is essential to create support for and a sense of urgency regarding the use of naloxone as a life-saving medication. Identifying where naloxone would make the most impact in saving lives within a community is critical. Some local leaders have advocated for access to naloxone for individuals re-entering neighborhoods from incarceration, given the high risk for opioid overdose at re-entry. By providing naloxone and training the use of it in prisons and jails before an individual’s release, overall opioid-related overdose deaths could be reduced. As one key informant suggested, “the best strategy is getting naloxone into incarceration.”
THE OPIOID CRISIS AND THE BLACK/AFRICAN AMERICAN POPULATION: AN URGENT ISSUE
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